On Call
by bewdofchaos
Summary: Dr. Yugi Muto is a first-year resident rotating through general surgery at Domino General Hospital. As part of his duties, he is required to take overnight call shifts to take care of the admitted patients and help in the OR. But one night, this amicable young doctor is forced to work with the one senior resident he cannot stand – Dr. Seto Kaiba. One-shot.


**A/N: Hey there. Some say "write what you know", so with this story I did just that. I've been writing this one shot intermittently over the last few months as a way to deal with my own burnout and it was initially never supposed to see the light of day. But hey, maybe someone here will relate or appreciate this. I tried to make it not too technical, but I'm sorry if I failed. The surgery names have no bearing on the plot. A small glossary is at the end of this fic if you're really curious.**

* * *

1805h:

Today has been a long day. I've been in the OR since 8 am, and in the hospital since 6. Two laparoscopic cholecystectomies, an appendectomy and a bowel resection later, my workday duties are done. That is, if this was a normal day.

But no, today I'm on call.

Quickly tossing my departmental fleece jacket over my scrubs, I hastily make my way to the inpatient ward to receive handover on the 60 patients I will be trying to keep alive overnight.

Call shifts are an interesting part of my job. You work your usual workday, then stay in the hospital all night admitting and taking care of patients. Then you round on these patients again in the morning, and finally head home to get some rest. These shifts usually amount to 26 hours of straight work, with a 30 minute nap here and there if you're lucky.

No, I'm not pulling your leg. This actually happens. At least I'm at a center that has a strict 26-hour rule for call. You see, I love my job. I really do. But on nights like tonight, I wish I'd decided to not listen to my biology teacher when she said I'd make a good doctor, and instead follow my dreams of becoming a tournament duelist. But alas, that's a gripe for another day. For now, I have to focus on running down these stairs so I can catch the senior residents before they leave for the day to avoid being stuck with a bunch of complex patients that I don't know anything about.

I find the ward conference room, yanking the door open to find the senior residents waiting for me, one of which looks particularly annoyed.

Hmm… maybe I should back up a step. Residents are medical doctors who are undergoing specialization. We are the backbone cheap labour of which the hospital runs on. In return, we get to learn and grow so one day we can take care of patients independently. Junior residents are usually years 1-2, and senior residents are years 3+. In some countries, I'd be called an intern at my stage of training, but here, we are just called first year residents, or R1s for short.

On these wards, the seniors supervise patient care while the juniors do the grunt work of correcting electrolyte deficiencies, pestering radiology for reports on imaging and managing acute deteriorations of the admitted patients. The seniors then gather the data from their daytime junior grunts, and fill in the night-time junior on what they need to do. The night time junior is not completely alone though, a senior resident is also on call to help out in the operating room or answer the junior's questions as needed.

"Yugi, what took you so long?" Dr. Atem Sennen, R3 asked evenly. "Handover starts at 6 pm."

"My apologies, Atem. Dr. Jones' last OR ran a bit late. I'm ready for handover whenever you guys are." I say apologetically.

"Hmph. Let's get this done quick, the call cases are starting." Dr. Seto Kaiba, R4 snipped.

Oh great, here we go again. Ladies and gentlemen, I present to you: Seto Kaiba. Now, a lot of residents are overworked, underpaid and underslept, but are genuinely nice people. I'm also the sort that tries to look for the best in others. But Seto, I don't know what's going on, but this guy is a grade A asshole. Every interaction I have with him leaves me with a bitter taste in my mouth. Anything I do or say seems to annoy him. I constantly feel as if I am the dumbest person alive whenever he looks at me with those blue eyes filled with displeasure. What have I said or done to deserve this? I'm generally pretty easy-going, but even just looking at him, with his smug air about him, makes me want to scream.

Oh, and did I mention, he's my senior tonight?

With a nonchalant flick of a wrist, Seto slides a patient list across the table towards me. I stop it, fish out my pen and start scrawling down the rapid-fire information that comes from the two seniors.

"Room 24 bed 2 – post op day 2 from an open chole. He's got the start of a wound infection. If he spikes a temp or becomes unwell, hit him with the big guns and grab blood cultures." Atem rifles off.

"Room 26 bed 1 – post op day 7 Whipple's for pancreatic cancer. Should be fine. Plan for discharge home tomorrow." Seto drones.

This goes on for close to five minutes, and by the end, I've doubted I retained any of that onslaught of information correctly. This is why good residents take notes.

"Well, I'm off to the OR now. Finish up the day tasks we left you. If you need me, page me. But if you do, it had better be good." Seto states, his dry voice laced with a warning tone. He stands up and saunters out of the room.

I sigh, turning to Atem. "That guy really doesn't like me, huh?" I say, trying to joke.

"Don't worry about him." Atem responds, his crimson eyes drifting up from his paper.

Oh yes, Atem Sennen. A prodigy known even outside of the surgical department. Legend has it, when he was at my level of training, he was able to confidently defeat senior residents during surgical skills workshops with ease. Apparently, he also has bested the other most promising recruit to Domino General Hospital's surgical program, Seto Kaiba, many times despite being a year his junior. I've even heard people refer to him as "the King".

"All you need to do is stay out of his way and this rotation will be over as soon as you know it. Then you'll get to look at histopathology slides to your heart's content. What a weird choice of career. I'd have guessed you to be a front-line kind of doctor." Atem remarks.

Oh yeah, did I mention… I'm not even here to become a surgeon? People like me in other specialties have to do rotations in related fields before we get to focus on our craft. Not so luckily for me, I have to do a general surgery rotation. With my intimidating look-alike and an obstinate, infuriating man who has a temper akin to a blue eyes white dragon.

God, I should have just become a tournament duelist.

Atem wishes me luck as he leaves, and I find myself alone in the conference room. Well, time to get a bit of food in me before the chaos starts.

* * *

1844h:

My first page of the night. I was expecting it sooner, but the gods were merciful today. Room 34 bed 2 was having chest pain. Again. Probably just heartburn, but we take this sort of thing seriously every time, because you never know when it could be a fatal postoperative complication or a heart attack.

I quickly collect my duel monsters cards that I had been practicing my combos with while I ate my disgusting hospital cafeteria dinner and rush up to the floor. A few minutes later, I finish talking to the patient and put my bloodwork, ECG and chest x-ray orders in. Very likely heartburn, but just to be safe, I will do the full work up. My pager shrills.

"4508. Where's that number from?" I mutter to myself. Well, it's the OR phone, and Dr. Stick-up-his-ass, erm, Dr. Kaiba, is livid. Apparently I was supposed to read between the lines and help out in the OR. Even though no other senior resident expects this of the overnight junior because the floor usually keeps us plenty busy.

"What part of 'call OR' do you not understand?" Seto snipes, finishing his mini-tirade. My head's spinning. I'm usually a pretty passive person, but I so desperately want to put him on blast. I hold my tongue, cause firing back never helps. Instead, I choose my usual approach.

"I am very sorry. The floor paged me and I went to deal with a sick patient."

"Hmph, you could have done that over the phone in the OR." Seto growls. "Next OR's in 15 minutes. I had better see you scrubbed in before me."

I hang up and take a deep breath to calm myself. I take to a tactic I have used since I was a teen whenever I get mad at someone. Closing my eyes, I envision myself duelling whomever has aggravated me (in this case, the insufferable Seto Kaiba), calling out to the Dark Magician to blow them to smithereens with a dark magic attack. This brings a smile to my lips, and I go to the locker room to change into a fresh set of scrubs.

* * *

1932h:

I am stuck in the OR once again, gripping onto a metal retractor trying to help expose the surgical site to the attending and senior resident as they work. My pager had already gone off three times since the OR started, and I've had to relay information though a OR nurse to deal with the pages all while Seto Kaiba glared at me every time I spoke.

"No, hold it like this." Seto grabs my hand roughly, pulling it into a position that suits his liking. "I need to see. Don't let that slide."

I hold that position until my arm starts to shake. I deftly switch hands, trying to maintain tension all the while. I fail. This earns me another Kaiba special.

"A monkey can do a better job than you, Muto." Seto sneers, his blue eyes narrowing maleficently at me from across the table. I supress roll my own eyes in response. Instead, I mumble an apology and reposition myself as best as possible.

This is going to be a long night.

* * *

2150h:

Finally, the OR is done. I have received enough pages during the surgery to keep the non-sterile OR nurse busy enough to hate me. Fortunately (or maybe unfortunately?) I never had to scrub out to attend to the admitted patients. I shed my sterile gown and help transport the patient to the PACU (post anesthesia care unit – where people recover from the anesthetics before being sent to a more permanent hospital room). I decide to head down to the floor to see if there are any less urgent tasks that need to be dealt with in the meanwhile.

Sure enough, a couple patients have arrived on the floor who were going to stay the night before their morning operations tomorrow. And of course, their paperwork was not done. On my way to the nursing station to grab some forms, I get headed off by a couple of nurses for non-urgent orders.

Now, if there's one thing I truly hate about my job, it's the paperwork. I feel like on an average day, I spend more time writing notes, filling out imaging requisitions and punching in medication orders then I actually spend doing medicine. And honestly, it's a drag.

I hunker down at a computer in the back and start my menial tasks. However, this is short lived as a nurse comes in and quietly, yet assertively positions himself in my line of sight.

"Uh, hello. What can I do for you?" I ask.

"I'm taking care of 24-2, and I was just about to call you about the fever he just spiked. But thankfully you're already here." The nurse said.

"Oh, yes that's the post op chole with the wound infection, right?"

"Yes, and honestly, I'm a bit worried about him."

Say no more_. _I lock the computer and get up out of my chair.

Nurses can be a real help when it comes to managing your nightly workflow. They see the patients a lot more than I will ever have time to, so they can pick up on subtle changes in patient condition. And one piece of advice I hold to heart is that if a nurse is worried about a patient, you go see that patient. Some of these people have a sixth sense, I swear.

Sure enough, I walk into room 24 bed 2, and the guy looks pretty rough. Respiratory rate's up just by looking at him and he's got a sheen of sweat gleaming on his brow.

"Hello, my name is Dr. Muto. I'm the resident covering for the night. But you can call me Yugi." I say, flashing a small reassuring smile. "How are you doing tonight?"

"Not so good. I'm so cold, and my gut's starting to act up again."

While I try getting a bit more information from the patient, I signal to the nurse – Bakura, was it? – to pull up the most recent vitals. As feared, his blood pressure's a bit lower than I'd like to see and his heart rate is too high.

I finish gathering information and ask if I could take a look at his abdomen and surgical incision. The patient is agreeable and as I pull away the gauze, I'm met with an angry, partially healed surgical wound.

Ok, this fits with the wound infection history I was given by Atem earlier. But he's on appropriate antibiotics… this can't be the only thing going on.

I move to examine the part of his abdomen farthest away from the incision, the left lower quadrant, and the patient jumps. His abdomen is firm and exquisitely tender.

You've got to be kidding me.

This guy is septic and peritonitic. Meaning, he has something very wrong with his abdomen, most likely a spreading abdominal infection. I need to get some blood work, bolster this patient's antibiotics, and run some intravenous fluids to buy some time. He may need an OR tonight. But first I need more information… and unfortunately, I should really call Seto about this.

* * *

2229h:

"Well, get a CT and pester radiology to get it done quick." Click.

Seto Kaiba, a man of few words. Although he was not actually annoyed by my call (most higher ups usually aren't if its something they may have to deal with themselves later on), Seto is still as curt as always. I guess its time to get that CT scan.

A CT, or CAT scan, is basically a fancy set of x-rays that we can use to look at the body part of interest to make management decisions. For example, do we take him to the OR, or do we just keep treating with medications? I scribble down the patient history on an imaging requisition and make the trek downstairs to radiology.

I enter the shadow realm, erm, diagnostic imaging department and start the hunt for the radiology resident on call. I can never find where they are hiding out in this darkened labyrinth.

Soon, I find a cubby hole illuminated by lamplight and poke my head in.

"Start numbering. Findings in keeping with acute appendicitis, without evidence of complication. General surgery consultation is advised." A low, barely perceptible mumble can be heard from the person sitting in the chair in front of a large computer workstation.

Great, that case is likely to come to my floor tonight once the general surgery consult team is done seeing. I suddenly becoming exhausted.

"Knock, knock." I say quietly to announce my presence.

The female resident turns away from the computer screen to survey me. Her short, pixie cut brown hair is slightly tousled, as if she had been running her hands through it while she worked. A small smile blooms on her face.

"Welcome to the shadow realm. How can I help?" She responds amicably as she places her digital dictaphone down and turning around fully in her chair.

"Oh hey! I think we've met before… Dr. Dow, right?" I respond with a smile.

"Yeah, but you can call me Allie. You're Yugi, the path resident right? What are you doing here at this ungodly hour?"

"General surgery." Enough said. She understands my pain, as she had to do this exact same thing when she first started too.

"I'm so sorry. You'll be done soon enough! You've got this, Yugi!" I can't help but smile back at her encouraging tone.

"Looking forward to it. Can I run a story by you?"

"Of course, what have you got?" Her friendly blue eyes gleaming slightly despite the dim lighting.

After a few minutes of chatting, the CT is approved and expedited because of the patient's sepsis. It should be done within the hour. I say goodbye to the resident and start finding my way out of the department.

* * *

2345h:

Shit. He's got a bile leak. And he's getting worse.

When they took out his gallbladder, they must have caused a small nick in the tube that carries bile. Really, all this boils down to is that this is a serious situation that needs another operation to fix. Or else this patient could…

_Just keep trying to stabilize him, Yugi. _I think to myself. I'm now back at the patient's bedside, who is not responding appropriately to the antibiotics and fluids I've given him. His vital signs are getting worse.

As I finish discussing with Bakura that he should start preparing a transfer up to a monitored bed ready for after the OR, a whirlwind kicks up in the room. Before I even have a second to register what was going on, I am hip-checked from my prime bedside position by a man much taller than myself.

"Hello, my name is Dr. Kaiba. I am the senior resident. Your scan shows that there has been a complication from your recent surgery, and we need to take you back to the OR. I'm here to discuss this with you further."

I listen for a minute or two before I realize that I will not be needed here anymore, so I go out to finish up the tasks I started up a couple hours back.

My pager has been blissfully silent… BEEP BEEP BEEP.

Fuck.

* * *

0104h:

I find myself heading back into the OR I had just escaped a few hours earlier. As I trudge into the men's change room to put away my stuff and change into my OR shoes, I'm met by an unexpected sight.

"Uhhh hi." Atem of all people is standing outside his locker, half changed into a set of scrubs.

What the hell is he doing here? "Oh hi, Atem. I… didn't expect to see you here. You're not on call!" I blurt incredulously. I'd sure as hell be asleep in my bed if I wasn't on call.

Atem chuckles, looking a bit sheepish. "I ultimately want to do hepatobiliary surgery, so I have asked the attendings to call me in at any time of day or night to help out if there's ever an appropriate case."

_"Damn_, you're dedicated." I respond impulsively, then quickly become aware of what I just said. "Ahh, sorry for swearing."

"It's no trouble, Yugi." Atem responds with a smile. "You don't have to walk on eggshells around me. I'm not Seto."

I laugh wholeheartedly at his quip. As he pulls on his scrub top and I fish out my OR shoes, we start to chat. We talk about nothing of importance, but it is nice to chat with someone who seems to genuinely care about my answers. There's something comfortable about our conversation, like I knew him in another life. We continue our conversation as we scrub in, and I get him laughing at one of my snarky comebacks as we walk through the OR door.

"If you two are done, we'd like to get started." Seto snaps, already gowned and gloved. The attending is there too, but seems to be unperturbed by our somewhat rambunctious entrance. Instead, he looks enthused to see the man beside me.

"Atem! It will be great to have your hands in on this case. I trust you've seen the CT?"

"Yes, he's got a pretty good leak going. This will be difficult." Atem responds, his confident voice carrying through the operating theater. The King has arrived, indeed.

"Seto, let Atem take first assist on this." The attending orders calmly. I swear I can feel Seto's thinly veiled anger rolling off him from several feet away. Seto slowly sidesteps out of the way, begrudgingly allowing Atem passage to the first assist spot. He shoots Atem, who is one year his junior, a scathing look. Atem does not even seem to register Seto's animosity, and he calmly grabs the scalpel to get the surgery started.

* * *

0500h:

I've hit pure exhaustion. The OR has just finished, and I am a dead man walking. As the more surgically oriented doctors in the room had feared, the surgery was difficult and not without its own near misses. We worked for hours. Well, they worked while I retracted and tried not to get hit in the face by Seto Kaiba's elbow.

A couple hours back, I was allowed a blissful reprieve from the OR as the floor needed me to check on a few other patients who have developed some problems while I was in the OR. I made sure to eat a quick snack before getting back into the OR fray.

I blearily help wheel the patient down to the PACU and start entering my post-operative orders. I check off the boxes and ensure that the big gun antibiotics continue to be run as this guy is still not out of the woods. I look at the clock.

One hour left until the day team takes over. I just have to make it one more hour.

My eyes are so dry they are burning. My mouth is dry. I can barely think straight. The last couple hours of a call shift are often the worst. Everything seems to hit you all at once. I don't know what I want more, a couple cups of coffee or 10 hours of sleep.

_Maybe I will do both today once I'm done. _I shove my hands in my pockets and start to walk back to the change room.

"Doctor!" A nurse calls, grabbing my attention.

The anesthesiologist also hears and returns quickly back to the bedside. The patient has gone from drowsy but responsive to completely unrousable. The cardiac monitor shows an unstable heart rhythm.

_Shit. Shit. Shit._

"Call a code!" The anesthesiologist barks as I instinctively start chest compressions.

_One-two-three-four-five… _I keep going at a steady rate until I see in the periphery that the anesthesiologist has a bag mask at the ready to give some breaths. I stop. Breath. Breath. I restart the compressions.

A minute later I hear a familiar deep voice behind me, smooth and even despite the tense situation.

"Yugi, I'm here for a switch."

"Ok Atem, during the next breath." I pant between compressions.

We seamlessly switch during the next breath, perfectly in tune. The code team arrives just over a minute into Atem's turn and takes over completely.

We take a couple steps back, joining Seto who had just arrived with the code team. All three of us watch in silence as the team tries a defibrillation shock. It works, much to my surprise. The patient is then further stabilized.

"Good." Atem murmurs, turning to address me with a small smile on his face. "I'm going to get ready for the day ahead. I will catch you later, Yugi." He walks off.

"You might want to change your post op orders. He's going to need a monitored bed. Rounds in under one hour." Seto's crisp words rung through the room as he spun on his heel and headed towards the stairway.

I tear off my surgical cap, running my hands through my hair as it returns to its naturally hectic state. I fix my orders and after a few more minutes at the bedside to reassure myself that the patient will be fine, I make my leave. I check my watch: 0517h. So close yet so far. Maybe I can make it to my call room for a quick power nap before I have to help round in 45 mins?

_Wouldn't I be so lucky._ My tired brain thinks as I head back to the locker room to change my shoes. My runners now back on and my feet dragging, I head back towards the stairs to exit the surgical floor. In my half asleep state I nearly barrel into a figure sitting on a step right by the door.

"Oh! My bad!" I instinctively say, jumping back slightly. "Wait… Seto?"

The man on the steps was indeed the last person I'd expect to see hiding out in a dingy staircase at five in the morning. His head was slightly hung, his posture slumped. He seemed… broken? This was short lived though, because the second he registered my voice, he seemed to regain his usual pompous and arrogant air momentarily.

"Yugi, what the hell are you doing here?"

"I work here?" My tired brain responds flippantly without decorum. Great, now I'm going to really get it. He hates being talked back to.

Surprisingly, Seto does not tear me a new one like I thought he would. Instead, he goes quiet and seems to crumble in on himself again. He places his head in his hands.

Now, this guy has been the bane of my existence. He's an asshole who has made an already tough rotation utterly soul crushing. He chides me every chance he gets. His cocky attitude makes him insufferable. However, seeing him clearly at his breaking point, sitting alone in a cold staircase, I do something I would have never thought I would have.

I take a seat next to him.

We don't talk. Neither of us makes a move to leave. Both of our pagers are miraculously quiet. Our phones stay in our pockets.

After a few minutes of silence, I dig around in my fleece pocket, pulling out a granola bar and hold it out as an offering. He takes it.

"Do you want to talk about anything?"

"No."

"Ok."

A couple more minutes pass before Seto moves to get up. He continues to look world weary and exhausted, but more composed than before. He looks at me, his eyes for once not filled with annoyance and displeasure. He looks… grateful?

"Thank you." He mutters quietly. He leaves.

_I hope he is going to be alright. _I think to myself as I get up and dust myself off. Looking at my watch, I realize I no longer have time for that nap. I blow a puff of air out defeatedly, causing my gold bangs to dance. I might as well get a head start on rounds.

* * *

0735h:

Rounding is complete. The discharge paperwork is finished. My night is finally done. Almost euphoric, I make the trek back to the resident lounge to grab my stuff and head home. I unlock my locker, feeling a dopy grin start on my face. I'm going to drink that cup of coffee and fall asleep for a good long while. Then maybe, I will enter the local Duel Monsters friendly tournament tonight if I can pry myself off of the couch.

I fish my deck out of my departmental fleece pocket, fanning it out. "This deck will put some people on their toes for sure!" I say excitedly to myself aloud.

I grab my jacket, deposit my deck safely inside a pocket and close my locker door, revealing a person standing at his locker just a couple feet away.

"Oh hey Atem!" I greet warmly.

"Yugi! On your way out? You deserve a long rest after that night." He returns in kind.

"Yeah, I'm beat. I don't know how you guys do it. Surgical call is so busy." I groan.

"I don't know either." Atem responds pensively. He shakes his head and his smile returns. "Anyways, did I hear you mention a deck? Do you play Duel Monsters by any chance?"

Shit. I said that out loud didn't I?

"Uh yeah, I do. I wanted to become a tournament duelist when I was a teen, but life kind of got in the way." I say embarrassedly, rubbing the back of my head.

"I play too. A couple friends and I play once a week. I've never played in an official tournament, though." Atem responds, his crimson eyes joyful and his smile widening. "You should really join us sometime!"

"Really? I'd like that!" I respond. Atem motions to me to hand my phone to him.

"We usually play on Tuesday nights, assuming none of us are on call." He says as he pulls up a contact and punches in his number. "Send me a text so I have yours too. Anyways, I have an OR I need to be in. Have a good rest and I will see you Tuesday!"

Maybe this rotation is not so bad after all.

* * *

**Glossary:**

**Laparoscopic cholecystectomy/chole: gallbladder removal through tiny incisions **

**Appendectomy: appendix removal**

**Whipple: complex procedure to take out part of the pancreas and adjacent small bowel.**

**Pager: a small, outdated device that tells you to phone people rather than have them actually call your phone. Its often possessed by a sadistic demon that might that should be chucked out a high window whenever you are given the chance. **


End file.
